Sunday Morning~ Blantyre

Last September I was searching for ways to be helpful to the faculty. I felt like I wasn’t very busy and should have been doing more. One of the midwives told me to take advantage of the quiet time because our program is overloaded and there will be a time this year when I’ll wish there was nothing to do. Well, those days are here.

Second term has started and the course I’m co-teaching, that we thought was supposed to start tomorrow, actually started last Monday. We haven’t even written the curriculum yet. A week ago I still didn’t know what I was supposed to be teaching this term. I have four hours of lecture tomorrow starting at 7:30 a.m. at a campus thirty minutes away. I haven’t even started putting together a presentation.The students were sitting in class waiting for us last Monday, the day their term started, and we didn’t show up. The first year students start tomorrow, but for some reason, the second year students started last week. This was news even to Ursula, who is the dean of our program. Can I wing it tomorrow for four hours? I guess have to break my rule of not working on the weekend and spend this evening making a power point.

On the ride to Lilongwe last weekend, I talked a lot about the frustrations I have with how women are treated here. Two of my colleagues were in the vehicle heading to meetings and I’d hitched a ride with them. It ended up being a good brainstorming session. I started venting about the treatment of women and how hard it is to teach theory and the principles of good care and then send students to the clinical setting where they hardly get any supervision and see women being treated terribly. I asked how are they supposed to learn to be advocates for women? It’s crushing me.

They both listened and shared my frustrations. Ursula, our dean, said she has a dream of having a faculty practice at Queens Hospital where the practice is run by midwives and we mentor students so they can see what real midwifery care should be. I jumped all over that. It would be fantastic! We wouldn’t have to be driving all over the country to supervise them and we could create an environment of respectful care! I asked how we could do that; what would it take to make it a reality? Well, they said, we’d need money to start. They both laughed and said, “That’s where you would have to help. We’d need you to find a donor.” I told them I’m not friends with Madonna, so don’t get any ideas. Just because she’s American doesn’t mean I know her. (Madonna has adopted kids from Malawi and she has donated money to build a big state-of-the-art children’s hospital here. It’s impressive to say the least, even in it’s half-done state.) But then I said, “But, yeah! Where does she think those kids start anyway?!” That got a laugh and a glimmer of hope. But I told them even if I could finagle an introduction to her when she comes next, money is the easiest thing about this. How would we sustain it? Who would pay the salaries? I don’t believe in projects that rely on continual funding from another source. It would have to be self-sustaining. We painted a broad picture in big strokes of what it might be like and then my mind started wandering and I had a huge fantasy of having a unit set up right near campus where we ran the show. We would only call for medical consult when we identified the need. No more medical rounds at 9 a.m. and 3 p.m. where a posse of med students and residents surround a woman’s bed, discusses her case as if she were a mannequin, take turns examining her without consent, make a plan, instruct whatever underling they see in a white uniform to carry out their order, toss the chart back on the bed, and turn to the next victim. I’m thinking they won’t be too eager to give up that power. I told my colleagues, the money is the easy part. Getting the medical school to stay away until we call them is going to be the problem. I told them if I had an opportunity to float the idea with someone from the embassy or with Peace Corps I would.

On Sunday I got a ride back to Blantyre with staff from Peace Corps and SEED Global Health. I brought up the idea of a faculty practice and discussed an actual path forward with it. Our in-country SEED representative told me there was a scientific conference for midwives on May 3rd to 5th in Malawi and that I should try to attend and bring this up. When I opened my email Monday morning, there was a call for abstracts to present at this same meeting. I thought that was downright prophetic. I ran with it to my colleagues and said, “We should submit our idea! Let’s write it up and present it at this meeting!” The theme is ‘Midwives protecting the lives of mothers in the workplace!’ This could get some momentum!” Elizabeth said, “Yes! Let’s bang our heads together!” Ok, so let’s see…..we’ve got an idea, we’ve got enthusiasm, we’ve got a need, we’ve got some of the resources. What don’t we have? Right now, I’m feeling like it’s clout, but I didn’t want to sound like a Debbie Downer. I asked Ursula what kind of a fight we could expect from the medical school? She acknowledged it would take some finessing. She is well connected though, and if there’s one thing they do here it’s meetings, so we’d have to have some meetings with key people. I need to get some statistics. I need to stay focused on the steps without jumping right to the final product. I can’t let myself get too disappointed if it doesn’t go smoothly. I’ve got to protect myself there. I’m so excited at the thought we might be able to actually do something to improve women’s lives that I’m letting my heart run away with it. It’s like falling in love. It all sounds so good at the beginning. When it’s all theoretical the happy-ever-after seems assured. But then, you know, reality sets in and it all goes to hell and you look like an idiot for even believing it could work in the first place. And then I think are we really going to be able to create this model ward? Really? When we can’t even let the faculty know the schedule for the beginning of second term? But, if we can be aware of all those things, then maybe, maybe we can come out with something that works. Maybe we can create a model ward that gets replicated all over the country! Maybe it will be so popular that we’ll have to expand! Maybe, if we show we have better outcomes people will see the light and it will become a standard of care! Oh wait, we’ve already done that at home. We’ve already shown the better outcomes. That’s right. And the well-fed white men in dark suits still sit around the table deciding how women’s lives should be regulated. Fuckers.

Walking home from church this morning I saw a man lying half on the road with his head on the sidewalk. He didn’t look injured but wasn’t moving. I crossed the road and looked closer to see if he was breathing. Another woman slowed her pace to look at him. Two young men came over and moved his legs so he was lying completely on the sidewalk. They looked up at me and said, “He’s drunk.” I asked if they thought he was alive? “Yes, he’s alive. He’s drunk.” The man moved his head ever so slightly, and the other two men kept walking. The woman kept walking. Then I kept walking. I was shocked at how little emotion I felt. I had no desire to help him. I was glad for the other people around, but really felt no compassion at all. I thought, it’s the first of the month. Pay day was Friday. They’re probably right. He probably drank most of his pay. I wondered if there was a woman at home with kids who were hungry. I crossed the bridge over the river littered with plastic bags. I walked up the hill and home.

It’s gotten late and I’ve got to get something together for tomorrow. Friends came over so we could discuss our plan for hiking Mt Mulanje over Easter weekend. We needed to coordinate the food and supplies and we put together a Huevose Rancheros for lunch which was actually quite good. We had a great time for a few hours planning our trek, but now I’m regretting the gin and tonic and bottle of wine that went along with the merriment.

I need to make some tea and start writing some notes so I don’t look like an idiot tomorrow. I’ll let you know how it goes. Safe Motherhood Initiative and Respectful Women Care. I’m sure I can rant about that for four hours.